28513 Pages
3279 Words
Introduction Of Preparation for Professional Practice
The aim of this assessment is to design a reflective report on the episode of care in the final year of the study. Additionally, in this reflective report, the focus will also be given to the decision-making skills, leadership skills, and knowledge that have been acquired throughout the episode of care and healthcare coursework. More specifically, in this reflective report, the focus will be on the demonstration of knowledge and understanding of local, national, and international guidelines about healthcare policy and approaches, along with the importance of delivery and coordination of care. In this report, the processes of recognising treatment and referral for patients, safeguarding vulnerable individuals and de-escalation of the situation related to the mental health crisis have to be included with an in-depth analysis.
For this proposed assessment, Rolfe's reflective model has been used to shed light on the personal experiences and knowledge being acquired through the final years of the care study. Rolfe's reflective model is based on three simple questions: what? So what? Now What? In this assessment, the personal experiences and knowledge related to the management of fatal bradycardia, mental health crises, and fluid balance.
Struggling to find the assignment help online in the UK? New Assignment Help has you covered! With our specialized assignment services in the UK, you'll breeze through your academic tasks effortlessly. And don't forget to download our assignment sample for reference.
Discussion
Episode of Care (Final Year)
WHAT?
During one of the episode care sessions, as a mental health nursing student, I was asked to go through the case scenario related with care program of the client understand how physical, behavioural, and verbal status or approach are important to check to determine the current needs of the patient. During the learning session, there was an important section where we learned about the following subject matter related with the care process of the patient:
- use of appropriate medication and equipment
- calibration
- the use of the good counselling process- to provide good health and well-being to the patient.
During the teaching session, I was asked to study the case scenario of Patient A. When I went through the case scenario of Patient A, I came to understand that this patient is going through a course of disease-related malnutrition (DRM), and that is why she is taking Fortisip as supplement in her dietary management process (Ahmad et al., 2022).
Additionally, Patient A is also taking medication for antipsychotic disorders. I was also asked to thoroughly go through the electronic patient journey system (ePJs) for Patient A. This ePJs is a mental health electronic health record database. This database has helped me understand her first episode of care. During this observation, I saw that Patient A has a denial behavioural approach as she wants to return home (Brewster et al., 2022). I informed Patient A that she was admitted to the hospital based on the Section 2 tribunal. Though, during the conversation, I realised that Patient A lacks knowledge about Section 2, under which any individual will consider being eligible for compulsory admission for assessment and treatment of mental health and wellbeing, During this conversation, I realised that Patient A is impatient to return home, and as a nursing student, my responsibility was to take good care of Patient A and help her overcome her trauma, stigma, and any dilemma about taking medication, food, and treatment for her mental health and wellbeing (House and Gwaltney, 2022).
SO WHAT?
In this episode, I had scope to gather knowledge and understanding about Section 2 of the Mental Health Tribunal Act, 2007 (amended and reviewed).
Additionally, during this care episode, I have gained several scopes or opportunities to learn the way of dealing with patients in a mental healthcare setup (Ellimoottil et al., 2017). For example, while checking the Electronic Patient Journey for Patient A, I came to understand several things (Campion et al., 2022). For example, through this episode of care, I came to understand that Section 2 of the Mental Health Act is a legal power that can allow any individual to be placed or admitted in a psychiatric hospital without taking any consent or will from the respective person. It also allows the hospital authorities to keep that individual with specific needs at the hospital for up to 28 days from the date of detention (Nyashanu et al., 2022). This episode of care has helped me understand the benefit of Section 2 of the Mental Health Act, by which a person, who is in urgent need of getting mental health care treatment and support can go through an assessment and possible medical treatment by a hospital. And this act is essential to protect that person from being discriminated against by society based on his mental health status, to protect other people, and to ensure the safety of that patient within society.
The second thing that I have learned from this care practice is to know more about disease-related malnutrition (DRM), for which Patient A has been prescribed Fortisip. This medicine is used to manage the dietary plan of the patient who is suffering from disease-related malnutrition and to meet the need for protein and energy within the body cells. Now, going through the electronic patient journey of Patient A, I came to realise that reduced dietary intake, increased nutritional loss, an alteration in metabolic demand, and malabsorption of nutrients (Shields et al., 2022). Fortisip is a ready-to-drink, high energy and nutritionally complete oral nutritional supplement. As patient A is suffering from malnutrition and malabsorption of nutritional diet, so she was prescribed to consume this oral nutritional supplement to maintain the balance of vitamins, minerals, protein, and energy in the blood and body cell of the patient (Cao et al., 2019). The balance between the nutrients and minerals in blood cell can help Patient A to develop immunity power and manage the Sodium-Potassium balance which in turn help her to lead a better mental health and wellbeing status.
The in-depth analysis of the case scenario of Patient A makes me realise that malnourishment or malnutrition can cause massive changes in the physiological function of individuals, which in turn can impact negatively on mental health and wellbeing as well as increase the chance of sudden death.
You need to be more analytical and less descriptive. Also use more references.
The third thing that I have learned from this episode of care is to gain in-depth and hands-on knowledge about dealing with a patient who has been admitted to a hospital under Section 2. For instance, in spite of knowing the current health condition of Patient A and the process of her admission to the hospital, I tried to showcase empathy towards her while she expressed her desire to go back home. I helped her by writing an appeal for early detention. I also tried to make Patient A convince that she is under the legal framework, where she is bound to take assessment and treatment from the hospital, based on her mental health status. Here I also ensure her that Section 2 of the Mental Health Act, 1993 does not outline the patient's responsibilities (Hon et al., 2021). This act emphasizes on the importance of involving the patient in the decision-making process regarding her treatment and care process. during this episode of care, I came to understand and conveyed to Patient A, that according to this legal framework, she has the right and autonomy to appeal to the court for getting appropriate support and treatment for her metal disorder. As per this tribunal, I suggested Patient A to appeal to the higher authority of the healthcare setup to consider her best interest, confidentiality and dignity by the healthcare professionals and care givers while accessing treatment (Albert et al., 2020).
This episode of care helped me understand the importance of communication when it comes to providing safety and assurance to patients with mental and physical illness. For instance, I tried to reassure Patient A that "I would inform hospital staff about her appeal for early detention" (Fusar-Poli et al., 2017).
I also tried to encourage her to take meals at the right time and in the right proportion to get rid of disease-related malnutrition. Similarly, my encouragement has helped her maintain trust in me, maintain her health and hygiene, eat well, and take good medication to get healthier.
NOW WHAT?
In an episode of Care 1, in-depth communication or interaction with the patient has helped me develop ideas about how to identify the patient's needs and how to initiate treatment or referral.
To elaborate, I tried to communicate with the patient effectively to ensure that she was in the best care. In addition, I conducted a handover in a person-centred way, meaning that I tried to consider the patient's needs and preferences on a prior basis. Additionally, I tried to provide the best advice about staying at the hospital for good treatment and appealing for early detention under Section 2 of the Mental Healthcare Act, 1993 (reviewed 2007) to the patient. This has helped me to develop and strengthen my empathy, listening skills, and communication skills (Himmerich et al., 2021). As a whole, during this episode of care, I have showcased good leadership skills, with which I have motivated and encouraged Patient A to take good care of herself on her own, starting from managing her own health and hygiene at the hospital to taking meals and medication at the right time and in the right way (Ellimoottil et al., 2017). Moreover, with good leadership skills, I have been able to establish clear expectations for Patient A, that she should get the best treatment and care support based on her needs and requirements. I also showcase good collaboration with other caregivers and healthcare professionals who were actively associated with the care practice of patient A. This leadership attribute has helped me to foster a positive work environment and manage a proper patient referral approach.
Additionally, I tried to provide accurate and concise information about the patient's current mental and physiological condition and treatment plan during the handover (Hon et al., 2021). However, during this episode of care, I tried to focus on the patient's perspective and her needs and desires.
For example, the treatment plan that I might suggest for patient A who is suffering from malnutrition and poor mental health condition will include:
Nutritional Assessment: Carefully assess the patient's dietary practices, nutritional status, and any underlying medical disorders that may interfere with nutrient absorption.
- Diet and nutrition: Create a customised meal plan to meet the patient's dietary requirements, making sure they get enough macronutrients, vitamins, and minerals. To make the plan as effective as possible, work with a licensed nutritionist (Hon et al., 2021).
- Examine the patient's mental health, particularly checking for signs of depression, anxiety, or other pertinent problems. Bring in a mental health expert to help with the evaluation.
- Provide counselling or therapy, such as cognitive-behavioral therapy, psychoeducation, or mindfulness practices, to address the patient's mental health difficulties. Encourage family support and participation (Albert et al., 2020).
- Medication Management: In cooperation with a psychiatrist or primary care physician, take into account drug options to treat any mental health issues that have been identified.
I also tried to use clear, concise, and respectful language by avoiding jargon and acronyms while dealing with or communicating with patients and providing her with relevant information like an appeal for Section 2 of the Mental Health Act (Fusar-Poli et al., 2017). Therefore, I have tried to work in collaboration with healthcare professionals, nurses, and patients to increase the likelihood of the treatment being approved for patient A based on her health status. I built positive relationships with Patient A (service users) and other healthcare professionals, which has helped me improve partnership work. In addition, during the episode of care, I tried to communicate or maintain liaison with other professionals so that I could seek advice regarding any needs, issues, or risks that arise while dealing with a patient like Patient A (Campion et al., 2022).
The major risks that can be arise while dealing with Patient A are:
Malnutrition can cause a number of medical issues, including electrolyte imbalances, decreased immune systems, organ dysfunction, and slowed wound healing (Albert et al., 2020). To avoid and manage these consequences during malnutrition treatment, vigilant monitoring may be necessary.
Nutritional rehabilitation challenges include the possibility of re-feeding syndrome when giving extremely malnourished people healthy food again. Rapid refeeding might result in fluid changes, electrolyte imbalances, and cardiovascular issues (Edanand Maylea, 2022). To reduce this risk, careful monitoring and a gradual increase in caloric intake are required.
Numerous medical conditions, including as electrolyte imbalances, weakened immune systems, organ dysfunction, and sluggish wound healing, can be brought on by malnutrition. Vigilant monitoring may be required during malnutrition treatment to prevent and control these effects.
The likelihood of refeeding syndrome while giving severely malnourished persons healthy food once more is one of the concerns of nutritional rehabilitation. Fluid shifts, electrolyte imbalances, and cardiovascular problems could occur from rapid refeeding (Kelly, 2020). Careful monitoring and a gradual increase in calorie intake are needed to lower this risk.
As a whole, it can be stated that I was able to support Patient A when it came to understanding her rights of appeal. For example, I tried to work in collaboration with Patient A and her legal advisor so that Patient A could access her right of appeal for early detention. I contacted the trust advocate and set up a date for the tribunal for patient A. I also tried to encourage Patient A to take care of herself, take medication, eat nutritional meals, and engage in activities to boost her mental health and wellbeing (Ahmad et al., 2022). During the entire episode of care, I could have focused on the daily healthcare plan for Patient A; however, I created time to listen to her needs and appeal. I helped her get discharged a week after her intervention.
During this episode of care, I came to understand that maintaining positive physician-referral relations is one of the most important approaches when it comes to ensuring success in healthcare practices. According to Glover-Thomas, (2019), a physical referral relationship refers to the common practice in medicine, where a doctor can transfer or refer a patient to other specialists when the patient's condition is outside of the doctor's area of expertise. Based on this concept, I have provided a referral to the mental care and wellbeing unit for Patient A. At the time of the first episode of care, I provide a referral to the patient to the mental care and wellbeing unit based on her health status and the Mental Health Act, Section 2 (Brewster et al., 2022).
During the time I dealt with Patient A, I faced several challenges and issues, like communication barriers, managing the patient's dignity, and convince her to adopt treatment processes and practices, and so on. Though my flexibility and adaptability helped me overcome those challenges during the collaborative work, during this episode of care, I came to understand the importance of each and every step used in the process of assessing and providing care and support to the patient with specific needs.
Conclusion
To conclude this reflective assessment, the focus has been given to the in-depth analysis of a single episode of care for Patient A. In this reflective assessment, the focus has been given to what I have learned in the final year of study from this episode of care. The final year of study from the Episode of Care will help me to develop my skills and knowledge regarding the delivery of care support and services by complying with local and national healthcare policies and regulations.
References
- Ahmad, K.A.B., Khujamatov, H., Akhmedov, N., Bajuri, M.Y., Ahmad, M.N. and Ahmadian, A., 2022. Emerging trends and evolutions for smart city healthcare systems.Sustainable Cities and Society,80, p.103695.
- Albert, F.A., Crowe, M.J., Malau-Aduli, A.E. and Malau-Aduli, B.S., 2020. Physical activity promotion: a systematic review of the perceptions of healthcare professionals.International Journal of Environmental Research and Public Health,17(12), p.4358.
- Brewster, L., Jones, E., Priestley, M., Wilbraham, S.J., Spanner, L. and Hughes, G., 2022. ‘Look after the staff and they would look after the students' cultures of wellbeing and mental health in the university setting.Journal of Further and Higher Education,46(4), pp.548-560.
- Campion, J., Javed, A., Lund, C., Sartorius, N., Saxena, S., Marmot, M., Allan, J. and Udomratn, P., 2022. Public mental health: required actions to address implementation failure in the context of COVID-19.The Lancet Psychiatry,9(2), pp.169-182.
- Cao, Q., Huang, Y.H., Jiang, M. and Dai, C., 2019. The prevalence and risk factors of psychological disorders, malnutrition and quality of life in IBD patients. Scandinavian Journal of Gastroenterology, 54(12), pp.1458-1466.
- Edan, V. and Maylea, C., 2022. A model for mental health advance directives in the new Victorian Mental Health and Wellbeing Act.Psychiatry, Psychology and Law,29(5), pp.779-787.
- Ellimoottil, C., Ryan, A.M., Hou, H., Dupree, J.M., Hallstrom, B. and Miller, D.C., 2017. Implications of the definition of an episode of care used in the comprehensive care for joint replacement model.JAMA surgery,152(1), pp.49-54.
- Fusar?Poli, P., McGorry, P.D. and Kane, J.M., 2017. Improving outcomes of first?episode psychosis: an overview.World psychiatry,16(3), pp.251-265.
- Glover-Thomas, N., 2019. Therapeutic jurisprudence and mental health tribunals: changing patterns of demand and its impact.Journal of Social Welfare and Family Law,41(1), pp.103-125.
- Himmerich, H., Kan, C., Au, K. and Treasure, J., 2021. Pharmacological treatment of eating disorders, comorbid mental health problems, malnutrition and physical health consequences.Pharmacology & therapeutics,217, p.107667.
- Hon, S., Ritter, R. and Allen, D.D., 2021. Cost-effectiveness and outcomes of direct access to physical therapy for musculoskeletal disorders compared to physician-first access in the United States: systematic review and meta-analysis.Physical Therapy,101(1), p.pzaa201.
- House, M. and Gwaltney, C., 2022. Malnutrition screening and diagnosis tools: implications for practice. Nutrition in Clinical Practice, 37(1), pp.12-22.
- Kelly, B.D., 2020. Emergency mental health legislation in response to the Covid-19 (Coronavirus) pandemic in Ireland: Urgency, necessity and proportionality.International Journal of Law and Psychiatry,70, p.101564.
- Nyashanu, M., Pfende, F. and Ekpenyong, M.S., 2022. Triggers of mental health problems among frontline healthcare workers during the COVID?19 pandemic in private care homes and domiciliary care agencies: Lived experiences of care workers in the Midlands region, UK.Health & social care in the community,30(2), pp.e370-e376.
- Shields, G.E., Buck, D., Varese, F., Yung, A.R., Thompson, A., Husain, N., Broome, M.R., Upthegrove, R., Byrne, R. and Davies, L.M., 2022. A review of economic evaluations of health care for people at risk of psychosis and for first-episode psychosis.Bmc Psychiatry,22(1), p.126.